June 28 - 29, 2007 Advisory Committee Meeting Minutes

Process of the Dietary Guidelines Advisory Committee

Dr. Pate, a member of the 2005 Dietary Guidelines Advisory Committee, was
asked to give an overview of the working process employed by the Dietary
Guidelines Advisory Committee.

Dr. Pate outlined his overview as a summary of the overall process, comments
on the physical activity component of the Dietary Guidelines, a review of some
of the conclusive statements from the Guidelines and comments on the food
guidance system that resulted from the process.

The Dietary Guidelines have been an important government function since 1980
with a revision cycle every 5 years. Physical Activity was not really included
in the process until 2005, although was alluded to in earlier iterations. The
2005 Committee was charged with updating the earlier set of Guidelines and not
to start from scratch. The Guidelines provide science-based advice for people
ages 2 and up in areas related to health promotion and prevention of chronic
disease. From a policy perspective they provide the government a vehicle in
which to speak with a unified voice providing advice to "consumers" and
impacting certain federal programs and policies.

The 2005 Dietary Guidelines process was focused initially on the formation of
an Advisory Committee, organized into sub-committees, which submitted a report
to the Department of Health and Human Services and the Department of
Agriculture. The Committee was encouraged to be evidence based in the approaches
that were taken and the process was very time-limited and open to the public.
Once the report was submitted the Committee's work was over.

Early deliberations of the Committee produced a set of research questions
thought to have significance for nutrition guidance and policy. There was then a
preliminary review of peer-reviewed literature, a reconsideration of some of
those questions, some of which dropped off the list based on lack of evidence in
which to make a recommendation. High priority was given to randomized clinical
trials but observational studies were given a great deal of consideration as
well. The work of the Committee was preceded by several IOM panels that produced
Dietary Reference Intake Reports providing important input and background
material. The Committee went through several rounds of review and comment before
recommendations were made. The Physical Activity Guidelines process will have a
similar challenge to the Dietary Guidelines process in terms of communicating
complicated scientific data to the public in ways that are readily
interpretable.

The 2005 Dietary Guidelines produced 2 recommendations on Physical Activity.
The first primary recommendation stated that to reduce risk of chronic disease
in adulthood, people should engage in at least 30-minutes of moderate-intensity
physical activity. The second recommendation focused on weight management which
stated that to help manage body weight and prevent gradual unhealthy weight gain
in adulthood, people should engage in approximately 60-minutes of moderate to
vigorous-intensity physical activity. It was important to note the language from
the second recommendation was not identical to the report submitted by the
Committee as there was editing and modification between the Committee Report and
the actual Guidelines.

An example of where the Committee's work was not incorporated in the actual
Guidelines but subsequent implementation products is the "My Pyramid" guidance
system. The Committee spent time discussing the concept of discretionary
calories in which the more active a person is the more discretionary calories
are needed to maintain energy balance. Language to this effect was not included
in the Guidelines; however, the concept was incorporated in My Pyramid which
energy intake is scaled based on a person's level of physical activity.

A question was asked whether the 2010 Dietary Guidelines Advisory Committee
has been established in order for both groups to consult each other on areas of
overlap. While the 2010 Dietary Guidelines Committee has not been established,
Dr. Pate indicated it would be useful for this Committee to refer back to the
Dietary Guidelines themselves as well as the actual report from the Committee.